Spinal cord injury (SCI) results from various causes, including sports-related incidents, degenerative cervical myelopathy, traffic accidents, and falls. SCI typically leads to sensory and motor dysfunction and even paralysis. Current treatments for SCI include systemic administration of high-dose steroids and surgical decompression and stabilization. However, excessive use of glucocorticoids may increase susceptibility to infections and systemic bleeding. The long-term effect of surgery intervention remains unclear, with ongoing debates regarding its timing, efficacy, and safety. Therefore, innovative approaches are urgently needed to alleviate secondary injuries and promote spinal recovery. One emerging therapeutic approach for SCI is modulating the microenvironments to achieve neuroprotection and neurogenesis during recovery. Several biomaterials with favorable physicochemical properties have been developed to enhance therapeutic effects by regulating microenvironments. This Review first discusses the pathology of SCI microenvironments and then introduces biomaterials-based regulatory strategies targeting various microenvironmental components, including anti-inflammation, anti-oxidation, reduction of excitotoxicity, revascularization, neurogenesis, and scar density reduction. Additionally, the research and clinical application prospects for microenvironment regulation are presented.

中文翻译：

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微环境调节生物材料增强脊髓损伤治疗


脊髓损伤 （SCI） 由多种原因引起，包括运动相关事件、退行性脊髓型颈椎病、交通事故和跌倒。SCI 通常会导致感觉和运动功能障碍，甚至瘫痪。目前 SCI 的治疗方法包括全身使用大剂量类固醇和手术减压和稳定。然而，过量使用糖皮质激素可能会增加对感染和全身性出血的易感性。手术干预的长期效果尚不清楚，关于其时间、疗效和安全性的争论仍在继续。因此，迫切需要创新方法来减轻继发性损伤并促进脊柱恢复。一种新兴的 SCI 治疗方法是调节微环境，以在恢复过程中实现神经保护和神经发生。已经开发了几种具有良好物理化学特性的生物材料，通过调节微环境来增强治疗效果。本文首先讨论了 SCI 微环境的病理学，然后介绍了针对各种微环境成分的基于生物材料的调节策略，包括抗炎、抗氧化、减少兴奋性毒性、血运重建、神经发生和减少疤痕密度。此外，还介绍了微环境调控的研究和临床应用前景。